Sex differences in functional brain connectivity signatures of personalized TMS outcomes

Brisbane Convention & Exhibition Centre 

Growing knowledge of the link between brain connectivity and transcranial magnetic stimulation (TMS) treatment response has driven recent advances in target refinement and, in turn, treatment efficacy in major depressive disorder (MDD). Notably, mounting evidence suggests that prospectively targeting TMS to dorsolateral prefrontal cortex (DLPFC) sites according to connectivity with the subgenual anterior cingulate cortex (sgACC) might improve therapeutic outcomes in adult MDD.1–6 However, outcome variability remains, with sex differences widely implicated as a contributor7, yet the potential mechanism underlying this difference has remained unexplored.

Here, we explored whether sex differences may exist in DLPFC-sgACC functional connectivity. We also assessed the potential contribution of sex to variability in clinical outcomes in 51 adult patients who received personalized connectivity-guided TMS for treatment of refractory MDD.